TEL: 401-567-7700

12. Matrix offers a confidential Employee Assistance Program (EAP) for the use by employees and their family through Coastline by calling 1-800-445-1195. *

True

False

13. The host facility may have safety policies and procedures that differ from Matrix’s, however, I will adhere to the expectation outline in this video. *

Yes

No

Address *

Thank you for completing the Safety Quiz. Remember Do Your Job Safely. If needed, you will hear back within 48-72 hours.

By submitting this quiz, I am confirming that I watched the 2018 safety video in its entirety and understand the information that was presented. I acknowledge that if I am uncertain of a specific topic or have any question, I can contact the Safety Department for more information.

Date and time *

3. I am an experienced worker so I can make the decision when it is acceptable to remove the handle from my grinder because I need to get the job done. True or False?

True

False

14. I am authorized to take pictures and videos during work hours, upload them to social media and tag the host facility. *

8. My connector (C), retractable (yoyo) must connect me to my anchor point that is over my __________. *

9. The Lift Director will complete this form prior to every pick and communicate the plan with all team members: __________ *

Email

7. My body harness (B) must be __________ before each use. *

Full Name: *

10. Oxygen and Acetylene bottles must be separated by a __________ barrier and properly secured with ___________ or ___________. *

15. It is my responsibility to maintain my work area at all times – this is called: *

OCD

Housekeeping

Not necessary

2. When a hazard is recognized in my work area that is not identified in my JHA, I must immediately REPORT it to my Supervisor and complete which form? *

Hazard analysis and correction form

Hazard recognition and mitigation form

Hazard identification form

1. Matrix’s risk assessment identifies the hazards, controls and procedures for every job task. This is known as the Job __________ Analysis (JHA) and I am required to sign __________ and sign __________ each shift. *

2019 Safety Quiz

6. My anchor point (A) must support __________ pounds. *

11. Matrix maintains a firm standing that every employee will only work if that individual is mentally and physically fit to perform their job task safely because every job position is “safety __________.” *